How are residents involved?

With staff guidance, residents participate in all aspects of the rural/wilderness SEKI EMS system. These include: continuing education of the Parkmedics (monthly classes), continuous quality improvement, an annual refresher course, a special biannual training course (see Parkmedic Primary Training Course), and wilderness/EMS research. Interested residents also have the opportunity to observe and participate in medical leadership on a national level as our faculty, Dr.’s Stroh, Campagne, Young and Macias, serve as National EMS Medical Advisors to the NPS.

Goals of the Parkmedic program include the following:

• Upon graduation, residents will have the skills to direct any kind of EMS system in the country. Many past residents remain actively involved in NPS EMS, including
  • Dr. Braude – class of 2000, is the state EMS Medical Director for New Mexico)
  • Dr. Dillon – class of 2006, is the Co-Director of the ‘Survivor Course” and Medical Director for Death Valley National Park, Joshua Tree
  • National Park, and Mojave National Preserve)
  • Dr. Eric Cooper
  • Dr. Jacoby Allen
  • Dr. Hakkarinen

• Residents will build a working knowledge base in wilderness medicine.
• Residents will have the opportunity to pursue personal areas of interest in wilderness medicine/EMS
• Residents will participate in a scholarly project/research of their choice.

Involved residents have free access to the Park (only 45 minutes away) and frequently enjoy various back-country activities including:

• Back-country snow surveys – one to seven day cross country ski tours with a ranger surveying the snow pack in various areas
• Search and Rescue training
• Camping, climbing, caving, hiking, snow-shoeing and more!

What is the Parkmedic Primary Certification Course?

The Parkmedic Primary Certification Course is a seven week training and certification course held every two years. Park rangers from national parks throughout the United States attend this course. UCSF Fresno Parkmedic residents, other interested residents, faculty, and staff give lectures, hold small group sessions and lead clinical rounds. Parkmedic faculty, who are all emergency medicine physicians at UCSF Fresno, are both SEKI and NPS EMS Medical Advisors and oversee this national Parkmedic training program.

What are Continuous Quality Improvement (CQI) and Continuing Education (CE)?

CQI provides a way for SEKI EMS providers to receive feedback on the treatment they provide in the field. Parkmedic residents review the runsheets used for documentation and provide suggestions on how to improve the next medical encounter via individual or group education or protocol revision. These suggestions are then relayed to the Parkmedics at either CE sessions by their EMS coordinator or by Parkmedic Program faculty.  CE is emphasized and monthly educational lectures are held in Sequoia and Kings Canyon National Park. In addition, there are

• An annual EMS Provider refresher course
• A bi-annual Parkmedic Refresher course
• An annual multi-casualty incident (MCI) drill.

What other EMS experiences are available for UCSF Fresno EM residents?

The eight main objectives for the California EMS Act are: manpower and training, communications, transportation, assessment of hospitals and critical care centers, system organization and management, data collection and evaluation, public information and education and disaster response. These components are also used within the NPS EMS and SEKI EMS systems. UCSF Fresno Emergency Medicine residents have many opportunities during their training to learn more about EMS and become involved in the local Central California EMS system ( www.ccemsa.org ). For more details see the UCSF Fresno Emergency Medicine Resident EMS Curriculum.

What is SEKI Tactical EMS?

UCSF Fresno EMS staff in conjunction with the NPS EMS advisory council developed a teaching course based on military medic techniques and tactics.  Selected Park Rangers are given training in providing medical care under combat situations.  A training course is followed by biannual refresher courses. Participants are taught to identify patients with survivable injuries, hemorrhage control, treatment of penetrating chest trauma and evacuation strategies.

What contributions to the National Parks Service (NPS)/Sequoia Kings National Park (SEKI) EMS have been made over the years by the Parkmedic Program?

National EMS Leadership – Parkmedic faculty serve as advisors to EMS leadership nationally

NPS/EMS workshops and conferences – EMS faculty, as well as many of the Parkmedic residents, have attended, presented, and facilitated sessions at NPS and ANPR.

Parkmedic Primary Certification Course – this seven week course has trained the majority of the Parkmedics in the NPS.

Research – many publications have been generated from this program. There is always an ongoing list of current research projects/scholarly activities. Residents have the opportunity to join existing projects or develop their own research projects based on personal interest in specific areas of EMS and wilderness medicine. (link to published research)

Standardized EMS provider protocols – In conjunction with national EMS leadership our residents produce and edit protocols for Parkmedic EMS providers. (link to LEMA website)

Standardized NPS Patient Care Report – most documentation is done electronically using a form edited by our program.

Tactical Medicine – Training modules and protocols were developed by EMS Faculty and Parkmedic residents that are now used nationally.

Training Modules – Epinephrine and Fracture/Dislocation Reduction modules were developed here and are used nationally.

Multi-Casualty Incident (MCI) Drill – Annual MCI drill directed and taught by Parkmedic residents overseen by faculty to help prepare rangers to handle the pressures associated with multi-casualty incidents.

PGY4 Parkmedic residents can designate “EMS/Parkmedic” as their Area of Concentration (AOC). Of note, residents are expected to log a designated amount of time to complete their AOC. If the resident does not want “EMS/Parkmedic” as their sole AOC they can split it with any other area of interest (eg. EMS/PM and Ultrasound, EMS/PM and Pediatrics, etc.).

As a PGY4 Parkmedic resident, you take a leadership role in one of four areas which include administration/operations, continuing quality improvement (CQI), training/continuing medical education, or National Park Service (NPS)/national focus.

Monthly Parkmedic Resident Meetings
4th Tuesday Each Month 1830 – 2000

Faculty Meeting Times
Monthly office hours during which residents can meet with faculty to discuss projects can be arranged by the resident

Training Courses
Parkmedic Primary Certification Course
7 week, 160 hours didactic and 96 hours clinical, bi-annually January – February (odd numbered years)

]Parkmedic Refresher Course
40 hours, bi-annually, February

EMT Refresher Course
24 hours, annually, June

MCI Drill
8 hours, annually, August

Tactical Medicine Refresher
4 hours, biannually, April and June

CE Sessions
3 hours, monthly, 1st Monday of every month